• Journal of Chest Surgery
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• v.44 no.6
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• pp.392-398
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• 2011

Background: The tetralogy of Fallot (TOF) with pulmonary atresia (PA) and a ductus-dependent pulmonary circulation (no major aorto-pulmonary collateral arteries (MAPCAs)) has been treated with staged repair or primary repair depending on the preference of surgeons or institutions. We evaluated the 19-year outcome of staged repair for this anomaly to find out whether our surgical strategy should be changed. Materials and Methods: Forty-four patients with TOF/PA with patent ductus arteriosus (PDA) who underwent staged repair from June 1991 to October 2010 were included in this retrospective study. The patients with MAPCAs were excluded. The average age at the first palliative shunt surgery was $40.8{\pm}67.5$ days (range: 0~332 days). Thirty-one patients (31/44, 70%) were neonates. The average weight was $3.5{\pm}1.6$ kg (range: 1.6~8.7 kg). A modified Blalock-Taussig (BT) shunt was performed in 38 patients, classic BT shunt in 4 patients, and central shunt in 2 patients. Six patients required concomitant procedures: pulmonary artery angioplasty was performed in 4 patients, pulmonary artery reconstruction in one patient, and re-implantation of the left pulmonary artery to the main pulmonary artery in one patient. Four patients required a second shunt operation before the definitive repair was performed. Thirty-three patients underwent definitive repair at $24.2{\pm}13.3$ months (range: 7.3~68 months) after the first palliative operation. The average age at the time of definitive repair was $25.4{\pm}13.5$ months (range: 7.6~68.6 months) and their average weight was $11.0{\pm}2.1$ kg. For definitive repair, 3 types of right ventricular outflow procedures were used: extra-cardiac conduit was performed in 30 patients, trans-annular patch in 2 patients, and REV operation in 1 patient. One patient was lost to follow-up after hospital discharge. The mean follow-up duration for the rest of the patients was $72{\pm}37$ months (range: 4~160 months). Results: Ten patients (10/44, 22.7%) died before the definitive repair was performed. Four of them died during hospitalization after the shunt operation. Six deaths were thought to be shunt-related. The average time of shunt-related deaths after shunt procedures was 8.7 months (range: 2 days~25.3 months). There was no operative mortality after the definitive repair, but one patient died from dilated cardiomyopathy caused by myocarditis 8 years and 3 months after the definitive repair. Five-year and 10-year survival rates after the first palliative operation were 76.8% and 69.1%, respectively. Conclusion: There was a high overall mortality rate in staged repair for the patients with TOF/PA with PDA. Majority of deaths occurred before the definitive repair was performed. Therefore, primary repair or early second stage definitive repair should be considered to enhance the survival rate for patients with TOF/PA with PDA.

• Korean Journal of Ecology and Environment
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• v.46 no.4
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• pp.488-498
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• 2013

A three-dimensional hydrodynamic model was applied to the Lake Euiam. The lake has three inflows, of which Gongji Stream has the smallest flow rate and poorest water. The dam-storage volume, watershed area, lake shape and discharge type of the Chuncheon Dam and the Soyang Dam are different. Therefore, it is difficult to analyze the water plume and mixing pattern due to the difference of the two dams regarding the amount of outflow and water temperature. In this study, we analyzed the effects of different characteristics on temperature and conductivity using the model appropriate for the Lake Euiam. We selected an integrated system supporting 3-D time varying modeling (GEMSS) to represent large temporal and spatial variations in hydrodynamics and transport of the Lake Euiam. The model represents the water temperature and hydrodynamics in the lake reasonably well. We examined residence time and spreading patterns of the incoming flows in the lake based on the results of the validated model. The results of the water temperature and conductivity distribution indicated that characteristics of upstream dams greatly influence Lake Euiam. In this study, the three-dimensional time variable water quality model successfully simulated the temporal and spatial variations of the hydrodynamics in the Lake Euiam. The model may be used for efficient water quality management.

• Korean Journal of Ecology and Environment
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• v.49 no.4
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• pp.354-374
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• 2016

This study explored spatiotemporal variability of water quality in correspondence with hydrometeorological factors in the five stations of Paldang Reservoir located in the Han River during 4 years from May 2012 to December 2015. Variability of basic water quality factors were largely related with seasonal fluctuations of hydrology. Temperature stratification occurred in the deep dam station, and prolonged hypoxia was observed during the draught year. Nitrogen nutrients were increased with decreasing inflow in which changing pattern of $NH_4$ reversed to $NO_3$ by the effect of treated wastewater effluent. Phosphorus increase was manifest during the period of high inflow or severe drought. Chl-a variation was reversely related with both flow change and AGP(algal growth potential) variations. Our study demonstrated that water quality variability in Paldang Reservoir was largely attributed to both natural and operational changes of inflow and outflow (including water intake) based on major pollution source of the treated wastewater (total amount of $472{\times}10^3m^3d^{-1}$) entering to the water system from watershed. In the process of water quality variability, meteorological (e.g., flood, typhoon, abnormal rainfall, scorching heat of summer) and hydrological factors (inflow and discharge) were likely to work dynamically with nutrients pulse, dilution, absorption, concentration and sedimentation. We underline comprehensive limnological study related to hydro-meteorolology to understand short- and long-term water quality variability in river-type large reservoir and suggest the necessity of P-free wastewater treatment for the effective measure of reducing pollution level of Paldang drinking water resource.

• Journal of the Korean Society of Marine Environment & Safety
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• v.28 no.2
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• pp.201-211
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• 2022

At the center of the Noryang waterway, the Gwangyang bay area (including the Yeosu Strait) is located at the west, and the Jinju bay area (including Gangjin bay and Sacheon bay) is located at the east. Freshwater from several rivers is flowing into the study area. In particula,r the event of flood, great quantities freshwater flow from Seomjingang (Seomjin river) into the Gwangyang bay area and from Gahwacheon (discharge from Namgang Dam) into the Jinju bay. The Gwangyang and Jinju bay are connected to the Noryang waterway. In addition, freshwater from Seomjingang and Gahwacheon also affect through the Noryang waterway. In this study, we elucidated the characteristics of the tidal exchange rate and residence time for dry season and flood season on 50 frequency, considering freshwater from 51 rivers, including Seomjingang and Gahwacheon, using a particle tracking method. We conducted additional experiments to determine the effect of freshwater from Seomjingang and Gahwacheon during flooding. In both the dry season and flood season, the result showed that the particles released from the Gwangyang bay moved to the Jinju bay through the Noryang waterway. However, comparatively small amount of particles moved from the Jinju bay to the Gwangyang bay. Each experimental case, the sea exchange rate was 44.40~67.21% in the Gwangyang bay and 50.37~73.10% in the Jinju bay, and the average residence time was 7.07~15.36days in the Gwangyang bay and 6.45~12.75days in the Jinju bay. Consequently the sea exchange rate increased and the residence time decreased during flooding. A calculation of cross-section water flux over 30 days for 7 internal and 5 external areas, indicated that the main essential flow direction of the water flux was the river outflow water from Seomjingang flow through the Yeosu strait to the outer sea and from Gahwacheon flow through Sacheon bay, Jinju bay and the Daebang waterway to the outer sea.